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Home My WebLink About04-08-15 COrv'morvwEnliN oP vtrvrvSVLVnrvin REV-116�S%i"'�Y01 DEPMTMENi OF PFVFNIIE nu oF imoivioun.*a�� oeP*.zeoeo� ��.��o�, pENNSYLVAN IA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 020471 MSHAR DONNA M 1059D YORK RD DILLSBURG, PA 17019 ACN ASSESSMENT AMOUNT CONTROL NUMBER ----- --- .. 15110034 5996.60 ESTATE WFORMATION: Ssn�: . I FILE NUMBER: 2� � B-O2�4 I oECEOENT NnnnE: YURASEK MARY H I DATEOFPAYMENT: O4/OS/2015 I POSTMARK DATE: 04/08/2015 I couNrr CUMBERLAND I DATEOF DEATH: 02/03/2015 I � TOTAL AMOUNT PAID: 5996.60 REMARKS: CHECK# 1372 INITIALS: CJ sea� RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS euaEeu ov �xnrvxvun� *ues Pennsylvania lnheritance Tax : pennsylvania . pOBO% 280601 OEPNFTMENTOFPEVENOE w�zxxsaoee aa v�xa�ow� ��fOfR18�lOfi NOSICB ,,, �s....oe<.no ia• And Taxpayer Response pi�E NO. zi -15- C21�{ ACN 15110034 DATE 0&26-2015 Type of Accoun� . Estate of MARY H VUFASEK �Savings SSN 522-44-5707 Checking Date 2015 Trust DONNA M MSHAR CountyCUMBERLAND X Certificate # 0 1059 YORK RD OILLSBIIRG PA 17019-9009 0 C� � � � `� m c o m � � � � � o 'o � �n � � x � � o r'. am mm .� � �, oo .0 o - >. o 0 V �a �, 'O -a '9 .-. , o -.� 3 v � �i � �.. _ o =c� N r- m -{ r -� , N p MEMBERS isr Fcu provided the department with Ihe information below indicatiiig that at t`Y�e deatFS*bf the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: AccountNo.431657 Oate Establishetl 09-OB-2011 REGISTER OF WILLS Account Balance $46,624.66 � COURTHOUSE SQUARE CARLISLE PA 17013 Percent Taxable X 50 Amount Subject b Tae $23,312.33 Tax Rate X 0.045 NOTE': If tax paymenis are made within three months of the Potential Tax Due $1,049A5 decedenPs tlate of death,deduct a 5 percent discount on the tax Wi[h 5%Discount(Tax x 0.95) $(see NOTE') � due. Any inheritance tax due will become delinquent nine months �---- afterthe date ofdeath. PARr SteP 1 : Please check the appropriate boxes below. t A �No tax is due. I am the spouse of the deceased or I am the parent ot a decedent who was 21 years old or younger at date of death. Pmceed ro Step 2 on reverse. Do not check any other boxes and disregard fhe amount `/ shown above as Potenfial Tax Due. g �he information is The above information is correc�,no deduc�ions are being taken,antl payment will be sent arred. wi�h my response. Pmceed to Step 2 on reverse. Do not check any other boxes. p �7he tax rate is inwrrect � 4.5% I am a lineal beneficiary(parent,child,grandchild,etcJ of the deceased. (Select correct tax rate at right, and complete Part � �p/ I am a sibling o(the deceased. 3 on reverse.) � 15% All other relationships(including none�. p �Changes or deductions The intormation a6ove is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the 6ack of this lorm. E �Asset will be reported on The above-identified asset has been or will 6e reported and tax paid with the PA Inheritance Tax inheritance tax form Fetum filed by�he estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other 6oxes. Please sign and date the back of the form when finished. vApT Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment,and the estate is insuificient to pay[he deductible items. B. Vou paid the debts after the death of the decedent and can furnish proof of payment if requested by ihe department. (If additional space is required,you may attach B 1/2"z 11"sheets of paper.) Dale Paid Payee Descriplion Amoun[Paitl Total En�er on Line 5 of Tae Calcula�ion $ PART Tax Calculation 3 N you are making a corredion to the establishment date(Line 1)account balance(Line 2), or percent taxable(Line 3), please obfain e wrltlen carreciicn from the tinancial institutiun and a±tach it to�his form. L Enter the date Ihe account was established or litled as it existed at ihe dale of death. 2 Enter the total balance of the account including any interest accrued at ihe date ot death. 3. Enter the percentage of the accoun�lhal is taxable to you. a. First,determine ihe percentage owned by[he decedent. i. Accoun�s that are held"in Irust fOr'another or o�hers were 100%owned by�he decedenl. ii. For join�accounis established more than one year prior to the date of tleath, ihe percentage taxable is 100%divided by the rotal number of owners including the decetlenL (For example:2 owners= 50%, 3 owners=33.33%,4 owners =25%, etc.) b. Nex�,tlivide Ihe decedenfs percemage owned by�he number o�surviving owners or beneficiaries. 4. The amount subject[o tav is determined by multiplyinq ihe account balance by the percent taxable. 5. Enter the�o�al of any debts and deductions claimed imm Part 2. 6. The amount taxable is de�ermined by sub�racting�he debls and deductions trom Ihe amoun�subject to tax. Z En[er Ihe appmpriate tax rete irom Step i based on your relationship to the decedent. If indicating a diflerent tax rate, please state Q(fjpjy��g Q� pppF � your relationship to ihe decetlent - pp pqpy��pf R2v8A�9'.��` 1. Dale Established � .l *jww�".`*��"`. 2. Accoun� Balance 2 $ �ppm�" „[* � 3. PercenlTaxable 3 % � J 2 4. Amount Sublecl to Tax 4 $ 3 5. Debis and Deductions 5 - 4 �.'":;i� 6. AmountT�able 6 $ 5 ' �� ,y a 7. Tax Ra�e 7 X 6 ��*,4 , ;t�r� 8. Tax Due e $ 8 e�:�( . 9. Wi[h 5%Discoun�(Tax x .95) 9 x � � St2p 2: Sign and date below. ReNm TNO wmpleted and signed copies to the Regis�er oi Wills listed on the front o(this(orm, along with a check for any paymen[you are making. Checks mus�be made payable to"Register of Wills, Agent." Do not send payment directty to the Department af Revenue. Under penalty of perjury, I declare that the facts I have reported above are tme,correct and complete�o the best of my knowledge and belief. �f I � y�y�� wo�k - Z�/J=,�a 7��a� /��// , 'Vhi ll�� I��ij'l/LV�� Home �� 7 ' / / ��C1 ,ST� U7��J Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 , r - � � l � l a3 K '+ : z i — � � � \' � ' � G �� 1 � C C� ' n � � `a' � G r' � � ,�l �;; � � � _ � � � � ;, _ o � � D �:� _ � � � � _ µ �: _ n Y � = µ = Vd ' �J �,iV12�38WR� r � = 1tif;C� :SNVHd210 i t ;_ = d0 �?t31� � ` i _ �t� �� - ZS ZI Wd 8 8dd SIOi s�iiM �o a31si�3a t �� o a�i��o aaaaoaad 1 , ^ �